Breathe in… breathe out…

Carolyn Kavita Tauro - CNS
As we stand at a pedestrian crossing or walk by a bridge, and a vehicle passes by, letting out a cloud of smoke in our face, our immediate reaction is to fan it away with our hands. We are also quick to give the driver of the vehicle a stare and even make a comment about how unclean and unsafe the air in the atmosphere around us is.
That would be the air outdoors which is polluted every moment due to poisonous emissions from fuels of cars, buses and trucks. But have we ever paused to think about how safe is the air which we breathe inside enclosed spaces like our workplaces, homes, restaurants/pubs, schools, campus hostels and public transport? Indoor air pollution most commonly includes tobacco smoke and smoke from the combustion of solid fuels. Apart from these, other indoor air pollutants could be cooking oil smoke, kerosene smoke, incense smoke, mosquito coil smoke and pesticides.

Tobacco smoke

Do we see no harm in smoking in front of our two year old child? Does the smoke exhaled by the passenger in the taxi have no affect on the taxi driver? How bad can that be? It’s just a bit of smoke. Exposure to second hand smoke (SHS) causes a high burden of disease as does the direct use of tobacco. This burden is higher in low-income countries and affects women and children most of all. The WHO Framework Convention on Tobacco Control (FCTC) rightly avers that there is no safe level of exposure to tobacco smoke.

Worldwide, passive smoking or second hand smoke causes about 603,000 premature deaths in non-smokers every year. Women are at least 50% more likely to be exposed to SHS than men. While adults suffer from lung cancer, heart diseases and chronic respiratory diseases, children suffer from asthma, other respiratory infections and sudden infant death syndrome as a result of this totally avoidable exposure.

Some countries have introduced laws forbidding smoking in public areas. But what really matters is how well these laws are followed. Strong anti-smoking legislations have to be backed by equally strong implementation, which alas does not happen often. Surely, many of us have had our building corridor smell of smoke that is coming from the neighbour’s flat. Many of us must have also enjoyed the sweet odour of the flavoured sheesha/hookah from the table next to ours in an outdoor restaurant. But then if we have smelt it, we have inhaled it. How many of us smoke in our home verandah and then take our 3 year old in our arms the very next minute?

In an online survey held recently, 26.7% of the respondents said that they smoked in enclosed public areas where smoking wasn’t banned. 9.68% said they smoked in the car, taxi or auto rickshaw. About 10% smoked at their workplace and inside the house. While 57.14% said they would move away from other people who were not smoking, 17.86% said they would only do that if the others objected.

According to Kathryn Seymour, Communications Officer at International Union Against Tuberculosis and Lung Disease (The Union), “Every person has a right to breathe clean air that is not contaminated by carcinogens and other harmful substances. Smoke free indoor public places are one of the key measures that can be implemented to protect this right. Under the smoke free policy, bans on smoking should be implemented in all indoor and crowded outdoor areas, as well as campus vehicles. Designated smoking rooms within these areas should not be allowed because there is no truly efficient means of containing or extracting tobacco smoke. In order to improve compliance, it is strongly recommended that managers of facilities consider offering cessation support to staff who smoke or referring them to a separate cessation service. Banning the sale of tobacco products and banning tobacco advertising will also help with compliance.”

Solid fuels and biomass

The other most common form of indoor air pollution, especially in low income countries, is the pollution due to the combustion of solid fuels like coal and biomass such as cow dung and firewood. Globally, about 50% of all households and 90% of rural households use solid fuels as the main domestic source of energy.

Data from the Indian Census 2011 shows that 87.2 % of rural families and 33.6% of urban families in India use pollution creating cooking fuels. However, there has been a migration toward the use of Liquefied Petroleum Gas (LPG) especially in the urban areas in recent years. Most of urban India now uses LPG and Piped Natural Gas (PNG) while rural India still relies on solid fuels and biomass. This is not so much due to a lack of awareness but more due to lack of availability, accessibility and, most importantly, affordability of cleaner fuel options.

Sunita (name changed), who lives in a slum in Mumbai, says that most slum dwellers have changed from solid fuels to LPG or kerosene in the past few years, “It used to be very difficult for us when we used cow dung to cook our food. The house was always full of smoke and we were constantly coughing. Now that we have the LPG cylinders our visits to the doctors have decreased, although the cylinders are expensive to buy”.

Efforts aimed at the prevention of airborne diseases for children under 5 years of age, will not only improve the general health of our future generation but also reduce the child mortality rate in the country. Along with this, interventions to reduce exposure to indoor air pollution will also help us in the realization of the Millennium Development Goals (MDGs) -- the end to the requirement of collecting fuel for cooking will help women by decreasing the time burden promoting gender equality and empowerment (Goal 3); it will also result in more time being made available for education and other activities that could help them generate more income to help eradicate poverty (Goal 1); a nation’s progress towards environmental sustainability can also be monitored through the proportion of the population using solid fuels (Goal 7).

Air has been taken for granted far too long. Everyone has a right to breathe in clean and safe air and so every person has the responsibility to provide themselves, their families and their communities this right. Along with legislations that aim to reduce indoor as well as outdoor air pollution, let each one of us do our bit to contribute toward a cleaner and safer environment.